In this study, investigators propose to randomize 165 human immunodeficiency virus positive patients to one of three 16-week treatment conditions: (1) standard care; (2) standard care + cell phone-based adherence reminders; or (3) standard care + cell phone-based adherence reminders and contingency management. In this latter condition, patients will earn reinforcement for sending in time- and date-stamped self videos of antiretroviral therapy medication ingestion. Primary outcomes will include viral loads and self-report measures of adherence, and effects will be evaluated both during the treatment period and throughout a one-year follow-up. Investigators hypothesize that the cell phone reminder condition will improve adherence relative to standard care, and the cell phone reminder plus contingency management condition will have the best outcomes. Results from this study may have widespread implications for the use of cell phones as a novel technology to improve initial adherence to antiretroviral therapy, thereby reducing the spread of drug resistant human immunodeficiency virus strains to the community.

Patients will receive reinforcement in the form of vouchers for each video that they send in indicating adherence at the appropriate time.

Eligibility

Ages Eligible for Study:

18 Years and older

Genders Eligible for Study:

Both

Accepts Healthy Volunteers:

No

Criteria

Inclusion Criteria:

age > 18 years

initiating a new antiretroviral therapy regimen but not previously received > 2 antiretroviral therapy regimens and have a viral load >1000 copies/milliliter

one or more risk factors for poor adherence

English speaking

willing to use a cell phone to receive reminders and record medication ingestion for up to 16 weeks

able to read at 5th grade level and pass a brief quiz related to understanding the informed consent form

Exclusion Criteria:

living in an environment or has a visiting nurse that dispenses antiretroviral therapy medication

received 2 or more prior antiretroviral therapy regimens

participating in another antiretroviral therapy adherence study

uncontrolled psychiatric disorders

significant cognitive impairment

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01760759